title: Effect of physiological posterolateral rotatory laxity on early results of posterior cruciate ligament reconstruction with posterolateral corner reconstruction.
abstract: BACKGROUND
  The purpose of this study was to evaluate the influence of physiological posterolateral rotatory laxity on posterior cruciate ligament (PCL) reconstruction in terms of posterior stability and clinical outcomes.
  
  
  METHODS
  We retrospectively reviewed the records of sixty-five patients who had undergone arthroscopic PCL reconstruction with simultaneous reconstruction of the posterolateral corner from March 2004 to April 2009. Patients were categorized into three groups according to the amount of tibial external rotation at 90° of knee flexion on the uninjured side: Group 1 (<40°; n = 26), Group 2 (between 40° and 50°; n = 21), and Group 3 (>50°; n = 18). Knee instability was assessed with posterior and varus stress radiographs as well as with the dial test at 30° and 90° of knee flexion. Functional scores were assessed with use of the Lysholm score and the International Knee Documentation Committee (IKDC) score preoperatively and at the time of final follow-up.
  
  
  RESULTS
  At the time of follow-up, there was no significant difference among the three groups with regard to the mean side-to-side difference in posterior translation as measured with Telos stress radiography (Group 1: 3.6 ± 1.3 mm, Group 2: 3.3 ± 1.6 mm, and Group 3: 4.3 ± 1.6 mm; p = 0.098). There was also no significant difference among the groups with respect to knee stability as assessed on the varus stress radiographs or with the dial test at 30° and 90° of flexion. Finally, there was no significant difference among the groups with respect to the Lysholm or IKDC functional scores.
  
  
  CONCLUSIONS
  This study suggests that the instability of knees that have PCL and posterolateral corner injuries with physiological posterolateral rotatory laxity can be controlled successfully with PCL reconstruction and simultaneous reconstruction of the posterolateral corner. Physiological posterolateral rotatory laxity should not be considered a risk factor for abnormal knee laxity after PCL reconstruction with simultaneous reconstruction of the posterolateral corner.
authors.affiliation: Department of Orthopaedic Surgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea.
authors.forename: Sung-Jae
authors.initials: SJ
authors.lastname: Kim
authors.forename: Sung-Guk
authors.initials: SG
authors.lastname: Kim
authors.forename: In-Sung
authors.initials: IS
authors.lastname: Lee
authors.forename: Hee-Don
authors.initials: HD
authors.lastname: Han
authors.forename: Ihn Hwa
authors.initials: IH
authors.lastname: Chung
authors.forename: Sung-Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Venkat
authors.initials: V
authors.lastname: Gorthi
mesh_terms: D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology* / Q000534:rehabilitation / Q000601:surgery; D007718:Knee Injuries / Q000503:physiopathology* / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012399:Rotation; D055815:Young Adult